Doctor Robert MacArthur Interview
This day, we were able to interview California's resident orthopedist, Dr. Robert MacArthur, addressing the inquiries about his personal encounters with wrong site surgery and surgical burn incidents, as well as the broader topic of "events that should never occur".
Who is Dr. MacArthur?
Dr. Bobby MacArthur completed his studies from the Univ of California, Berkeley with a dual degree in Biochemistry and Physio. Throughout his time at the Univ, Doctor Bobby MacArthur used to be a renown athlete, competing on both several boxing and rugby squads.
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Subsequently, Doc Rob Mac enrolled at the Columbia P&S, and became elected president of the Columbia P&S School of Medicine (Now known as the Vagelos school of medicine). Robert MacArthur continued to conclude his orthopaedic training at Harbor UCLA.
Dr. Robert MacArthur Addresses the Incidents
Statistically, the occurrence of surgical errors typically is a one-time event in a career for every bone specialist, but this count jumps to four in each professional career for sports, hand, and spine specialists. Regrettably, numerous of these frequently do not document such instances, let alone, not discuss them openly. Dr. Mac carries a profound sense of pride about how he dealt with these unfortunate occurrences.
Instead of trying to cover up the situation, Doc Mac handled it differently
Dr. MacArthur’s Handling of the Wrong Site Surgery
Dr. Bobby Mac thoroughly investigated the underlying root causes of his two incidents, and published multiple works detailing how to prevent these occurrences
Gradually, gained recognition as a renowned authority in the field of accidents that can be avoided. He's penned a couple of articles in the leading orthopedic journal, The Journal of the American Academy of Orthopedic Surgeons. In order to helping other doctors avert future incidents, his first work walked the reader through the specific errors that happened that led to the incorrect surgical procedure.
The second paper, authored together with Dr. David Ring, addressed the topic of the "shame and blame game." Being accountable for these incidents is rare, as the usual reaction is blaming other parties. Dr. MacArthur stressed that accusations not just prevents surgeons from reporting their incidents but also takes away from the vital analysis of primary reasons that may prevent future incidents.
The Intraoperative Burn Incident with Dr. Robert MacArthur
In the context of discussing the surgical burn occurrence, Dr. MacArthur demonstrated the same dedicated investigative approach he applied to his research on wrong-site surgeries. For example, he reached out to the maker of the problematic clamp to determine if like burn events had occurred. The producer notified him that the clamp in question had been "discontinued." You can draw your own conclusions from that what you wish.
In order to avoid unequal temperature distribution in large hinged clamps, Doctor Mac performed a detailed investigation of the causes behind irregular temperature distribution in large-hinged clamps.
His research findings suggested that quick sterilization could cause uneven heating. He noted that nursing organizations recommend strongly against the use of flash sterilization unless an emergency situation arises like sterilizing a dropped component. Further inquiry revealed that the hospital at St. Joseph's was frequently employing rapid sterilization to ease back-to-back surgeries without needing to buy extra equipment trays.
In an effort to stop further burns, Dr. MacArthur notified the hospital at St. Joseph's of the risks associated with ongoing utilization of this particular clamp as well as the routine deployment of rapid sterilization.
Instead of blaming the clamp, Dr. MacArthur assumed accountability and made it clear that he was responsible for a mistake during surgery. He was advised that the clamp had a high temperature, but when he took hold of it, he found the handles to be at a comfortable temperature. In contrast to some surgeons who could impatiently use a towel to manage a too-hot clamp, he operated the clamp with no discomfort.
Shame and Blame, Dr. Robert MacArthur's Response
Regarding The perspective of Dr. MacArthur on response on the topic of the "culture of blame and shame," he highlights how the legal and the wider public often confuse the "captain of the ship'' concept with root cause analysis. According to this "in-command" perspective, the surgeon is held accountable for any adverse events that happen to a patient under their care. This makes it tempting for many to solely blame the surgeon for any incorrect surgical procedure.
Nonetheless, Dr. Robert MacArthur stresses that such an approach contradicts the core principles of identifying underlying causes. This form of analysis Dr. Robert MacArthur strives to thoroughly comprehend what caused a wrong site event in order to preferably avert similar incidents in the future. By resorting to shaming and blaming, not it not just hinder proper analysis of the root causes, but it additionally discourages other surgeons from reporting on their individual wrong site events, worried about the repercussions.
He did not recognize that the large, substantial-sized hinge of the clamp was considerably hotter. When he positioned the clamp against the shin area of the patient's leg, it caused a burn injury. At the time, he was proctored for procedural privileges at the CHOC Hospital during the incident, and neither the proctor nor Dr. Robert MacArthur were immediately aware of the burn.
Not until until after he had dictated the operative report that an attending nurse in the recovery room noticed a small red area on the anterior aspect of the patient's leg. Even then, he did not initially fully grasp the severity of the burn.
Doctor MacArthur references the air travel industry as an outstanding case of efficient root cause analysis. From its inception, aviation sector has strived to thoroughly comprehend the reasons behind each negative aviation occurrence rather than merely assigning blame to the pilot. Because of this dedication to understanding root causes, aviation sector boasts impressive safety records.
Nonetheless, Doctor MacArthur laments that healthcare field hasn't been able to completely embrace root cause analysis due to prevailing legal and public perceptions surrounding the "captain of the ship" concept. The sad consequence of this is that the frequency of avoidable medical mistakes remains unchanged, and the professional careers and reputations of many healthcare practitioners are unfairly tarnished.
The incidence of incorrect surgical procedures continues at an disturbing rate of one event per surgeon per career, and as high as four occurrences per surgeon's career for specialists in hand, spine, and sports.
Dr. Robert MacArthur “Sexual Harassment” Allegations
In the year 2023, there exists the possibility to raise false accusations against someone, defame their name and reputation, and have no negative repercussions for the accuser. Regardless if the individual being accused is innocent or guilty, just making an allegation is enough to cause long-lasting damage to a professional's reputation.
Dr. Robert Mac disclosed that he chose to leave a clinic specializing in workers' compensation cases because of potential illicit activities on the clinic's management. In retaliation, the clinic's manager supposedly conspired with a client to fabricate a claim, accusing him of "undressing in the clinic and soliciting sexual favors in return for a positive workers' compensation report.
He was informed of this allegation over a year after his departure from the clinic, at which point he asserted on undergoing a polygraph examination. The accuser, however, refused to take such a test.
Doc Robert Mac was later notified that both his truth verification test results and her refusal to participate would be regarded inadmissible in court.
The attorney facilitating the mediation cautioned him that the jury would likely be composed of "her peers" and not his, meaning a court loss could be extremely detrimental. Despite the ludicrousness of the claim, he was counseled to settle for $29,000
Conclusion
The Medical Board of California examined the accuser's claims and found them to be "lacking credibility," hinting at an ongoing investigation into the clinic. When we spoke to Dr. MacArthur, he suggested that the clinic was indicted, but he did not confirm this.
Despite the information provided earlier, Dr. Robert MacArthur found no means to remove the accuser's claims from online search listings. This means, despite his lack of guilt, the campaign to tarnish his reputation was effective.
As the claim does not state that Doctor MacArthur was found guilty, it merely serves as a condensed version of a complaint, which continues to be available to the public
Dr. MacArthur strongly believes that people making false claims should receive punishments equivalent to the consequences of the falsely claimed event. To illustrate, he thinks that his false accuser should be classified as a sexual predator and felon.
Doctor MacArthur concluded by thinking about the coexistence of goodness and malevolence in the world, wishing that those who read his account would never come into contact with someone capable of such destructive unfounded claims as he has faced.